374603625-10-18-2023-08-AS-SJAB-CX5MRX-20231031095104

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603625
Report Date: 10/18/2023
Date Signed: 10/18/2023 05:10:02 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/09/2023 and conducted by Evaluator Daniel Pena

COMPLAINT CONTROL NUMBER: 08-AS-20231009153315

FACILITY NAME:	STELLAR CARE		FACILITY NUMBER:	374603625
ADMINISTRATOR:	LINDA CHO		FACILITY TYPE:	740
ADDRESS:	4518 54TH STREET		TELEPHONE:	(619) 287-2920
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	120	CENSUS: 80	DATE:	10/18/2023
		UNANNOUNCED	TIME BEGAN:	01:07 PM
MET WITH:	Brandon Cho, Assistant Administrator		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Staff did not meet resident's toileting needs

INVESTIGATION FINDINGS:

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On 10/18/2023, at about 1:07 PM, Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced visit to commence a complaint investigation. LPA identified himself and discussed the allegation mentioned above with Brandon Cho, Assistant Administrator.

On 10/9/2023, the Department received a complaint, alleging a resident was not receiving timely toileting assistance from staff. The Department’s investigation consisted of LPA observation, record reviews, and interviews with residents, staff and outside sources.

A sample of residents were interviewed. Each resident was cognizant, organized and verbally able to communicate with LPA. Residents advised LPA that they are satisfied with the responsiveness of staff. The residents said they’ve not been told by other residents nor witnessed untimely assistance and care. Residents said they had no complaints about anything about the facility.

Staff interviews detailed the procedures for providing resident incontinent care. LPA reviewed Resident 1 (See LIC811 Confidential Names to identify R1) bladder and bowel incontinence care records with staff.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20231009153315

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: STELLAR CARE	FACILITY NUMBER: 374603625
	VISIT DATE: 10/18/2023

NARRATIVE

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Staff interviews indicate that although R1 requires incontinence care the resident commonly refuses the care. Staff does check R1 which is documented in the resident's care records. The affected resident's Progress Notes revealed no lapse in incontinence care.

R1 was interviewed and stated that they are independent and do not require incontinent care. The resident said it is very rare that they wait for staff to assist them to the restroom or change them. The resident again for clarity told LPA that they do not require assistance with toileting. The resident also told LPA that they recently received a room change which has its own restroom so care is definitely not needed. The resident did not know why the allegation was made as they do not have a complaint regarding incontinent care.

Interviews with outside sources did not produce information to corroborate the allegation. Outside agencies stated that the facility keeps them informed of issues related to residents involved in their programs. Outside advocate agencies did not have information to support the allegation and said the facility is generally well managed. LPA's observation during the walk through of the facility did not present evidence that residents are not being changed regularly. There were no malodorous odors present; a common condition present where residents are receiving regular toileting assistance.

The Department has investigated the allegation that a resident is not receiving timely toileting assistance. Based on interviews and record review the investigation failed to produce evidence to support the allegation. The preponderance of evidence standard was not met; therefore, the allegation is deemed unsubstantiated.

An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Assistant Administrator, Cho, whose signature below confirms receipt of these rights.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023

LIC9099 (FAS) - (06/04)

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